Early Intensive Behavioral Intervention (EIBI) is an intervention which applies the principles of Applied Behavior Analysis (ABA) to teaching the developmental milestones that may be either missed or delayed to young children diagnosed with Autism Spectrum Disorder (ASD). EIBI is typically provided for children between the ages of two (2) and six (7) years old (Eikeseth, Smith, Jahr, & Eldevik, 2002, 2007; Waters et al., 2018; Vea et al., 2017), and involves the intensive delivery (30-40 hours per week) of one-to-one ABA treatment, systematically targeting a comprehensive curriculum based on typical childhood developmental milestones. The purpose of EIBI is to “close the gap,” between children’s chronological age and their developmental age, which may be delayed as a result of their diagnosis, and ultimately, to teach them the skills so they may best be prepare to enter school within the least restrictive environment. EIBI has a much stronger empirical basis than virtually any other intervention used with children with autism and is considered ‘‘best practice’’ for young children with autism (Eldevik, Titlestad, Aarlie, and Tonnesen, 2019).
The intensity of treatment/treatment dosage (number of hours per week of intervention) is a salient feature of successful EIBI. The best reported treatment outcomes were based on treatment in which 30–40 hours per week of one-to-one EIBI was delivered (Lovaas, 1987; Smith et al., 1997; Sallows and Graupner; 2005; Howard et al., 2005; Granpeesheh, Dixon, Tarbox, Kaplan, and Wilke, 2009). According to Makrygianni and Reed (2010), it appears that more intensive programs, in general, have a higher impact on the gain in intellectual, and adaptive behavioural abilities of children with ASD. Several studies have evaluated clinical outcomes for low-intensity interventions (below 15 weekly hours). Even though these studies report clinically meaningful gains, the gains are more moderate than studies reporting outcomes of more intensive behavioral intervention (Eldevik et al., 2012; Lotfizadeh, Kazemi, Pompa-Craven, & Eldevik, 2018).
Although EIBI is provided in several different ways it involves some common core elements: a) it blends research from ABA, ASD and child development, b) it addresses all the important skill domains, c) skills are broken down into teachable units and built up step by step, d) it is based on positive reinforcement to build new skills and reduce problem behaviors, e) procedures to reduce problem behaviors are based on functional analysis, f) direct observation and data collection are used for selecting new targets and evaluations, g) many well-documented behavior analytic procedures are used, both child-initiated and adult-directed methods (such as discrete trial teaching), h) intervention is individualized to the needs of the child and the family, i) it is conducted in many settings, j) parental involvement, k) explicit generalization training, and, l) it is designed and overseen by professionals with appropriate training (Green, 2011; Eldevik, Titlestad, Aarlie, and Tonnesen, 2019).